ISSN# 1545-4428 | Published date: 19 April, 2024
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At-A-Glance Session Detail
   
Close to the Bone: Osteology & Soft Tissues
Oral
Musculoskeletal
Wednesday, 08 May 2024
Nicoll 2
08:15 -  10:15
Moderators: Jung-Ah Choi & Catherine Muchuki
Session Number: O-31
CME Credit

08:15 Introduction
Jung-Ah Choi
Hallym University Dongtan Sacred Heart Hospital, Korea, Republic of
08:270767.
Comprehensive evaluation of wrist kinematics using 3D real-time MRI
Ye Tian1, Abhijit J. Chaudhari2, and Krishna S. Nayak1
1Ming Hsieh Department of Electrical and Computer Engineering, University of Southern California, Los Angeles, CA, United States, 2Department of Radiology, University of California Davis, Davis, CA, United States

Keywords: Functional/Dynamic, MSK, wrist, low-field, real-time

Motivation: A thorough understanding of wrist kinematics and kinetics is essential for diagnosing and treating wrist pain and instability. Current MRI methods are limited to tracking just a few thick slices and therefore use hand supports to restrict motion to pre-selected, simplified orientations.

Goal(s): To develop a 3D real-time MRI method at 0.55T for comprehensive evaluation of wrist kinematics.

Approach: A bSSFP 3D stack-of-spiral sequence with long spiral readout was implemented for evaluating wrist kinematics during maneuvers. 

Results: Comprehensive 3D coverage at 10 frames/second was achieved without any restriction on wrist motion, providing measurements of ligament intervals in 3D and during active wrist motion.

Impact: The proposed 3D real-time method can potentially improve diagnosis of wrist injury and dysfunction and treatment planning, by providing a unique 3D evaluation of wrist kinematics and kinetics during the performance of clinically-important maneuvers involved in activities of daily living.

08:390768.
Patella Shape is Associated with ACL Injury and Changes in KOOS and T1rho Following ACLR
James R Peters1, Nancy Obuchowski1, Naveen Subhas1, Valentina Pedoia2, Sharmila Majumdar2, Hollis Potter3, Matthew Koff3, Kimberly Amrami4, Cale Jacobs5, Carl Winalski1, Kurt R Spindler1, and Xiaojuan Li1
1The Cleveland Clinic Foundation, Cleveland, OH, United States, 2University of California, San Francisco, San Francisco, CA, United States, 3Hospital for Special Surgery, New York, NY, United States, 4Mayo Clinic, Rochester, MN, United States, 5Brigham and Women's Hospital, Boston, MA, United States

Keywords: Osteoarthritis, Bone, Patella, Shape, ACL, PTOA

Motivation: PTOA progression is poorly understood and there is a relative dearth of data available on the impact of the patellofemoral joint on PTOA.

Goal(s): The goal of this study was to elucidate the relationship between PTOA, knee function, and patella shape and to investigate possible indicators for PTOA progression.

Approach: A shape model of the patella was used to explore longitudinal shape changes and associations with injury, sex, KOOS, and cartilage T1rho in 67 patients following ALR and 11 controls.

Results: Ipsilateral patella shape was found to be associated with ACL injury, sex, and the degenerative changes accompanying PTOA.

Impact: This study suggests patella shape may play a role in ACL injury and PTOA. These results should inform future biomechanical studies of the knee joint which could lead to the development of preventative orthoses and novel interventions.

08:510769.
Neural Shape Models Meaningfully Localize Features Relevant to Osteoarthritis Disease: Data from the Osteoarthritis Initiative
Anthony A Gatti1, Louis Blankemeier1, Dave Van Veen1, Brian A Hargreaves1, Scott L Delp1, Feliks Kogan1, Garry E Gold1, and Akshay S Chaudhari1
1Stanford University, Stanford, CA, United States

Keywords: Osteoarthritis, MSK, shape model, MOAKS, osteophytes

Motivation: Osteoarthritis is a whole joint disease that requires quantification, localization, and visualization of disease related features of bones and cartilage.

Goal(s): To develop a novel neural shape model (NSM) that can encode and reconstruct bone and cartilage shape, while quantifying localized features of OA.

Approach: We trained a NSM on 6,325 knees and compared its reconstructions to a conventional statistical shape model and its ability to predict localized disease to a convolutional neural network.

Results: The NSM reconstructed tissues with cartilage thickness correlations >0.993. NSM representations accurately diagnosed OA and predicted localized severity of osteophytes and cartilage defects better than a CNN.

Impact: Our NSM can reconstruct whole bone and cartilage morphology, while encoding localized pathology specific information. Research use of the NSM can unlock novel insights into OA pathophysiology. Clinical deployment would enable automated insights into whole joint health.

09:030770.
Sigma-1 receptor changes in chronic knee pain using PET/MRI: Preliminary results of fifteen patients
Rianne A van der Heijden1, Luke Yoon2, Paul Yoon2, Guido Davidson2, and Sandip Biswal1
1University of Wisconsin-Madison, Madison, WI, United States, 2Radiology, Stanford University School of Medicine, Stanford, CA, United States

Keywords: Whole Joint, Molecular Imaging, Knee, Pain

Motivation: Diagnosis of chronic knee pain remains a challenge with conventional diagnostic methods leading to unsatisfactory treatment in a large group of patients.

Goal(s): To investigate the use of sigma-1 receptor (S1R) radioligand, [18F] FTC-146 in conjunction with positron emission tomography/magnetic resonance imaging (PET/MRI) for identifying the pain generator in chronic knee pain.

Approach: Comparison of [18F] FTC-146 PET-MRI imaging findings in patients with unresolved chronic knee pain to healthy volunteers.

Results: All 15 patients showed statistically significant increased uptake of S1R compared to healthy control subjects in a variety of locations. At sites of abnormal PET uptake, MRI often did not demonstrate abnormalities. 

Impact: Future clinical implementation of S1R-PET/MR can potentially help reveal previously unidentified pain generator in patients with chronic knee pain that have exhausted standard clinical care leading to better-targeted treatment. 

09:150771.
Bone Metabolic-Morphologic relation is Mediated by Gait; Cartilage Compositional-Morphologic relation isn’t: PET/MRI in Isolated PFJOA
Rupsa Bhattacharjee1, Eric Hammond2, Chotigar Ngarmsrikam1, Fei Jiang3, Misung Han1, Richard B Souza1,2, Valentina Pedoia1,4, and Sharmila Majumdar1
1Department of Radiology & Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA, United States, 2Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco (UCSF), San Francisco, CA, United States, 33. Department of Epidemiology and Biostatistics, University of California, San Francisco (UCSF), San Francisco, CA, United States, 4Altos Labs, San Francisco, CA, United States

Keywords: Cartilage, PET/MR

Motivation: Whether the compositional, metabolic, and biomechanical relationships have a mediated effect on one another is the next crucial step toward decoding the isolated PFJOA mechanism.

Goal(s): To investigate whether the relationship of morphological-joint-degradation with SUV-values from 18NaF-PET and cartilage-T2 in isolated-PFJOA are mediated by gait-biomechanics.  

Approach: Linear regression was performed between (i)WORMSBME(predictor) vs. Medial-SUVmax, Lateral-SUVmax (outcomes), and (ii) WORMSCartilage(predictor) vs. Mean-T2-Deep-Medial, T2-Superficial-Medial, T2-Deep-Lateral, T2-Superficial-Lateral (outcomes) patellar and trochlear. For significant correlations, mediation analyses were done to examine the role of Normalized-Mean-Peak vGRFIP as a mediator.

Results: WORMSBME vs. Medial-SUVmax, Lateral-SUVmax relationships are mediated by gait; WORMSCartilage vs. Mean-T2-Deep-Medial, T2-Superficial-Medial, T2-Deep-Lateral, T2-Superficial-Lateral aren’t mediated.

Impact: This is the first step towards understanding the flow of causalities and mediated interrelationships of bone remodeling (SUV), morphological degradation (WORMS), cartilage loss (T2), and gait biomechanics in a complex joint developing isolated PFJOA

09:270772.
Ripple Artifact Quantification in Slice Encoding for Metal Artifact Correction (SEMAC) using MR Bloch Simulation
Jonas Wahlen 1,2, Sebastian Kozerke2, Daniel Nanz1, Reto Sutter3, and Constantin von Deuster1,4
1Swiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zurich, Switzerland, 2Institute for Biomedical Engineering, ETH and University of Zurich, Zurich, Switzerland, 3Radiology Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland, 4Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Zurich, Switzerland

Keywords: Other Musculoskeletal, Artifacts, Bloch Simulator, Metal Artifacts, Implant

Motivation: Commonly used methods for the quantification of metal-induced image artifacts, such as measuring the extent of signal voids, do not capture spatial frequencies of ripple artifacts, as seen in dedicated metal artifact reduction sequences including SEMAC or MAVRIC. 

Goal(s): To propose a new method for the quantification of SEMAC ripple artifacts which may serve as quality metric for sequence optimizations. 

Approach: We applied a k-space-based metric to MR Bloch simulations of SEMAC sequences with variable slice thicknesses and RF pulse shapes (time-bandwidth product, TBW).

Results: A trend towards higher absolute artifact intensity and lower spatial frequency can be observed for higher TBWs.

Impact: The proposed metal artifact metric extends current quantification methods by taking the spatial frequency distribution of ripple artifacts into account. This may serve as a basis for metal artifact reduction sequence optimization, with a particular focus on RF pulse parameters.

09:390773.
Joint Embolization: Feasibility of Targeted Treatment and Response Assessment in the Shoulder, Hip and Knee Using Dynamic Contrast-Enhanced MRI
Eric M Bultman1, Lisa Mandl2, and Sirish Kishore1
1Radiology, Stanford University, Palo Alto, CA, United States, 2Rheumatology, Weill Cornell Medical College, New York, NY, United States

Keywords: Osteoarthritis, Perfusion, Embolization

Motivation: Embolization, a new treatment for chronic joint pain, may be more clinically effective when treatment is targeted using pre-procedural dynamic contrast-enhanced (DCE)-MRI.

Goal(s): Assess presence of synovitis and identify culprit arterial vessels using pre-procedural DCE-MRI.

Approach: Representative patients with mild-moderate osteoarthritis of the shoulder, hip and knee underwent fat-suppressed DCE-MRI using CDT-VIBE.  Imaging was performed with high temporal (6-7 sec/frame) and spatial (0.6 mm isotropic interpolated) resolution with 3-minute acquisition and 5cc/sec contrast injection.

Results: DCE-MRI readily identifies regions of synovitis and its contributory arterial vessels.  By exploiting contrast kinetics whole-joint synovial volumes can be semi-automatically calculated.

Impact: MRI-targeted joint embolization therapy has the potential to result in improved pain and functional outcomes with reduced side effects.  Rapid calculation of whole-joint synovial volumes may enable their use as a biomarker of arthritis severity and embolization treatment response.

09:510774.
Dynamic contrast-enhanced MRI of the synovium and synovial subregions in knee osteoarthritis
Jacob Marijn Mostert1, Tijmen A. van Zadelhoff1, Dirk H.J. Poot1, Edwin H.G. Oei1, and Rianne A. van der Heijden1,2
1Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, Netherlands, 2Radiology, University of Wisconsin Madison, Madison, WI, United States

Keywords: Osteoarthritis, DSC & DCE Perfusion, Synovium

Motivation: A precise method to quantify the degree of synovial inflammation in patients with knee osteoarthritis (OA) is needed to evaluate response to new disease modifying treatments in clinical trials.

Goal(s): To evaluate the repeatability of quantitative dynamic contrast enhanced (DCE) MRI derived biomarkers for synovitis quantification in the whole synovium and synovial subregions.

Approach: Test-retest study comprising DCE-MRI at baseline and 1 month follow-up in knee OA patients. Vessel mapping was used to determine synovial subregions.

Results: DCE-MRI biomarkers have good test-retest repeatability in both the whole synovium and synovial subregions, with Ktrans showing the best performance.

Impact: Quantitative DCE-MRI can provide precise biomarkers for synovitis quantification in knee osteoarthritis. Subregional evaluation using vessel mapping is an important tool for more precise treatment response evaluation in clinical trials with targeted local interventions, such as selective arterial embolization.

10:030775.
Temporal response of T2 and adiabatic T1ρ and T2ρ relaxation times to acute ischemic injury to the femoral head: an in vivo piglet model study
Casey P. Johnson1,2, Erick O. Buko1,2, Suhail Parvaze1,2, Douglas Albrecht1, Alaina L. Falck1, Alexandra R. Armstrong1, Jennifer C. Laine3,4, and Ferenc Toth1
1Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN, United States, 2Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States, 3Gillette Children's Specialty Healthcare, Saint Paul, MN, United States, 4Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, United States

Keywords: Bone, Ischemia

Motivation: Relaxation time mapping may be clinically useful to inform the severity of ischemic injury to bone marrow in osteonecrosis of the femoral head.

Goal(s): To compare the temporal response of T2, adiabatic T1ρ, and adiabatic T2ρ mapping to acute ischemic injury to the femoral head.

Approach: 24 piglets were imaged using 3D relaxation time mapping at 3T MRI before and after surgical induction of unilateral femoral head ischemia. Corresponding cellular changes were evaluated histologically.

Results: T2 and adiabatic T2ρ were the most sensitive in detecting acute injury to the femoral head, as early as 24 hours after onset of ischemia.

Impact: T2 and/or adiabatic T2ρ relaxation time mapping can potentially address a clinical need for a non-contrast-enhanced imaging technique to establish the severity and extent of bone marrow necrosis in the earliest stages of osteonecrosis of the femoral head.